Delaying Dental and Vision Care Can Be a Costly Mistake

Many employees have let their dental and vision coverage go unused since the COVID-19 pandemic spread throughout the U.S. in March. These employees should consider returning to their dentist and eye doctor, say dental and vision care providers, who advise that those who stay away from routine dental checkups and annual eye exams could be putting their teeth, vision and general health at risk.

As open enrollment gets underway, HR leaders are likely to inform employees of their dental and vision benefits. This year, it's also an opportunity to encourage workers to speak with their dentist and eye care provider about the safety measures that care providers have put in place for office visits, or the virtual care they may be offering.

Tooth and Gum Disease

"If teeth go uncleaned or under-maintenanced in general, I believe we are going to see a higher incidence of caries [decay and crumbling of a tooth or bone] and gum disease," said Todd Bertman, DMD, founder of Advanced Dental Arts in New York City.

On reopening his office after a two-and-a-half-month mandated closure, he has seen "a higher incidence of gum disease, more notably in the older generation" of patients. "In the younger generations, we are seeing an increase of grinding and clenching, and thus breaking and fractured teeth, due to stress-related grinding," Bertman said. "If these are left unchecked, this can easily lead to more costly treatment."

For example, he noted, "a broken or fractured tooth may need a crown if treated early. However, if left untreated it can result in an extraction and implant. If gum disease is left untreated, it can easily lead to tooth loss and further extensive treatment."

Kami Hoss, DDS, co-founder of The Super Dentists practice in Southern California, also pointed to problems caused when teeth go uncleaned and cavities unfilled.

"Oral health issues don't just pause because there is a pandemic," he said. "Dental cavities are likely to get bigger, gum infections will likely worsen, and orthodontic problems will progress, especially in children where their mouths are constantly growing and changing."

Surveys by the American Dental Association (ADA), Hoss said, show 15 percent to 25 percent of people are waiting for a medical breakthrough, such as a COVID-19 vaccine, before going back to their dentist. "That means they'll be avoiding the dentist for an entire year or more," he said. A likely result will be "an avalanche of costly health issues ranging from dental problems to whole-body systemic health issues," given that poor oral health "is linked to everything ranging from pregnancy complications to potentially life-threatening COVID-19 complications."

Hoss added, "when it comes to dental care, prevention and timely treatment are by far the best options."

Pediatric Dental Care

Delaying dental health care can be especially risky for children, Hoss said. "Forty-two percent of kids ages 2 to 11 will develop cavities. Enamel on baby teeth is thinner than on permanent teeth, and the pulp is relatively larger, so decay can spread to nerves faster," he noted. "For children with orthodontic problems, there is a limited window of opportunity during which treatment will get ideal results."

Even before the pandemic, parents often underestimated when and how frequently children should see a dentist, according to a 2019 study by Unum, a benefits plan provider. The study found that 36 percent of parents think young children (ages 3 to 12) should visit the dentist once a year at most, but dentists recommend a biannual checkup.

Eye Health

For vision care, as with dentistry, minor issues left untreated can lead to serious complications.

"Many patients may delay ocular care due to fear of social contact during the COVID-19 pandemic," but doing so can be detrimental to both eye health and overall physical health, said Liz Klunk, senior vice president of medical management at Versant Health, a provider of vision care insurance benefits.

Routine eye exams can provide a low-cost look at overall wellness, according to the American Optometric Association. In addition to eye diseases such as cataracts, macular degeneration and glaucoma, systemic diseases that can be diagnosed through a routine eye exam include high blood pressure, strokes and thyroid disease. Many people first learn they are diabetic through an eye exam.

"Employees enrolled in vision plans may mistakenly view a skipped eye exam as a pass on new glasses or contact lenses, rather than understanding eye exams as preventive medicine and the importance of healthy vision to overall wellness and lifestyle," Klunk explained.

Office Safety Precautions

To create a safer experience in the office, dentists are following ADA guidelines and recommendations from their state, Bertman and Hoss said.

Bertman noted, "Dentists have been prepared and trained for this sort of situation," especially since the 1980s, when the ADA adopted a protocol of universal precautions in response to the HIV/AIDS epidemic.

Under these precautions, dentists take an approach in which "every patient is assumed to be infectious and to treat each patient as such," Bertman said.

According to the ADA, there have been no COVID-19 infections to date that are attributable to a dental office. Hoss called this finding "a remarkable track record."

For vision care as well, "new safety protocols reduce the risk of COVID-19 transmission during office visits," Klunk pointed out.

"In most cases, eye exam visits are by appointment only, to limit the number of patients in offices and ensure those can properly socially distance," she noted. As with dental appointments, patients typically receive virtual health screenings prior to their appointment and have their temperature checked on arrival to the doctor's office. 

"Equipment is cleaned and disinfected between patients, and anyone in the office is required to wear masks or other protective coverings at all times," Klunk said.

Telehealth Options

"Teledentistry can be a virtual consultation tool for certain visits," Hoss said. A virtual appointment can be useful to discuss whether a dental issue warrants going to the dentist's office, and a cellphone camera or webcam may allow the dentist to virtually observe and diagnose the problem.

For comprehensive eye exams, "a patient may need to be in-office due to the equipment needed," Klunk noted. "That said, ocular telemedicine facilitates patient care by providing home monitoring for degenerative diseases like diabetic retinopathy and provides a safe option when an in-person visit isn't possible or poses a threat to patient health."

[Visit SHRM's resource page on open enrollment.]

Related SHRM Articles–Dental Care:

Bringing Personal Services to Work, SHRM Online, July 2018

Preventive Dental Benefits Save Employers Money, Studies Find, SHRM Online, February 2018

Dental Benefits Are Often Misunderstood, Underused, SHRM Online, July 2017

Give Your Dental Plan a Checkup, SHRM Online, August 2015 

Related SHRM Articles—Vision Care:

Screen Time Takes Toll on Workers' Eyes, SHRM Online, February 2020

Eye Strain at Work Is Up, Lowering Productivity, SHRM Online Benefits, February 2014